Headaches, such as migraines, and occipital neuralgia are often incapacitating and may lead to significant consumption of drugs to treat the symptoms. However, a rather large number of people are unresponsive to drug treatment, leaving them to wait out the episode or to resort to coping mechanisms. For refractive occipital neuralgia, nerve ablation or separation may effectively treat the pain.
Occipital nerve stimulation may serve as an alternative for treatment of migraines or occipital neuralgia. For example, a dual channel implantable electrical generator may be implanted subcutaneously in a patient. A distal portion of first and second leads may be implanted in proximity to a left and right occipital nerve such that one or more electrode of the leads are in electrical communication with the occipital nerves. The proximal portions of the leads may then be connected to the signal generator such that electrical signals can be delivered from the signal generator to the electrodes to apply therapeutic signals to the occipital nerves Alternatively, two single channel implantable electrical generators may be employed, where the first lead is connected to one signal generator and the second lead is connected to the second signal generator. In either case, the lead is typically tunneled subcutaneously from the site of implantation of the signal generator to the occipital nerve or around the base of the skull. Such tunneling can be time consuming and is invasive.
It may be desirable to reduce the amount of tunneling by placing the electrical signal generator in close proximity to the location of the nerve to be stimulated. Another way to reduce tunneling may be to tunnel a single lead extension having a distal end capable of receiving more than one lead to a location close to the nerves to be stimulated, and then coupling the leads to the extension. In either case, the implanted distance that the lead spans is greatly reduced.
For applications where nerves in the head are to be stimulated, it may be desirable to minimize or eliminate excess lead length. Typically leads are longer than needed to allow a given lead model or configuration to be used for a variety of purposes and in patients of varying size. Excess lead is typically wrapped or coiled in a subcutaneous pocket in which the electrical signal generator is implanted. However, in some areas of the body, such as under the scalp, coiling or wrapping of excess lead length may be uncomfortable for the patient in which the lead is implanted or may cause lead abrasion due to, e.g., rubbing against the skull.